Decision-making in musculoskeletal health care is a complex process, and
therefore disagreement concerning the ideal treatment pathway is not
unexpected.1 Clinicians striving to provide
evidence-based patient care have multiple subjective factors to
consider, and these multiple factors complicate decision-making. To
date, there has been a focus on specialist referral for musculoskeletal
injuries, including shoulder lesions, leading to expensive testing and
– potentially – unnecessary treatment.2-4Decision-making for shoulder treatment pathways has received little
attention in the literature, and the key clinical factors on which
decision-making is based remain unclear. This report will consider the
difficulties associated with musculoskeletal decision-making and present
a possible solution to improve clinical decisions based on multi-criteria decision-making , using shoulder injuries as a
model.